Women receiving 17-alpha-hydroxyprogesterone caproate hospitalized for preterm labor at less than 34 weeks benefit from daily perinatal nursing surveillance.
OBJECTIVE
The objective of the study was to compare pregnancy outcomes of women receiving 17-alpha-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent spontaneous preterm delivery (SPTD) hospitalized for preterm labor (PTL) less than 34 weeks' gestation prescribed daily vs weekly perinatal nursing surveillance.


METHODS
Singleton gestations with prior SPTD enrolled for outpatient 17P administration at less than 27 weeks' gestation were eligible. Women hospitalized for PTL at less than 34 weeks (n = 379) were identified. Women receiving daily perinatal nursing surveillance (dPNS) (n = 99) following PTL were matched by Medicaid status and gestational age at onset of PTL to women receiving weekly surveillance (n = 280), yielding 83 matched pairs.


RESULTS
Among patients receiving 17P who were hospitalized for PTL, the addition of dPNS following hospitalization resulted in lower rates of SPTD less than 32 weeks (odds ratio [OR], 0.29, 95% confidence interval [CI], 0.21-0.38) and less than 35 weeks (OR, 0.25, 95% CI, 0.17-0.33), whereas the rates of SPTD less than 37 weeks were similar.


CONCLUSIONS
Women receiving prophylactic 17P hospitalized for PTL before 34 weeks benefit from the addition of daily perinatal nursing surveillance.
Rittenberg
Charles
C
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
Sullivan
Scott
S
Istwan
Niki
N
Rhea
Debbie
D
Stanziano
Gary
G
Newman
Roger
R
D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D000553:Ambulatory Care; D005260:Female; D005323:Fetal Monitoring / Q000451:nursing* / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000451:nursing / Q000517:prevention & control*; D011372:Progestins / Q000627:therapeutic use*; D012189:Retrospective Studies; D055502:Secondary Prevention
D006908:Hydroxyprogesterones; D011372:Progestins; D000077713:17 alpha-Hydroxyprogesterone Caproate